Login | Register

An experimental approach to understanding beliefs about losing control in obsessive-compulsive disorder

Title:

An experimental approach to understanding beliefs about losing control in obsessive-compulsive disorder

Gagné, Jean-Philippe ORCID: https://orcid.org/0000-0001-5803-0489 (2017) An experimental approach to understanding beliefs about losing control in obsessive-compulsive disorder. Masters thesis, Concordia University.

[thumbnail of Gagne_MA_F2017.pdf]
Preview
Text (application/pdf)
Gagne_MA_F2017.pdf - Accepted Version
Available under License Spectrum Terms of Access.
3MB

Abstract

Cognitive theories of obsessive-compulsive disorder (OCD) posit that maladaptive beliefs lead to the development and maintenance of symptoms. However, currently identified beliefs (about responsibility and threat overestimation, perfectionism and intolerance for uncertainty, and about the importance of and control over thoughts) do not sufficiently explain OCD symptomatology. Anecdotal and other reports have documented concerns among those diagnosed with OCD regarding a potential loss of control over their thoughts and behaviour, indicating that negative beliefs about losing control may be an important cognitive domain involved in the aetiology of OCD. In this study, 133 undergraduate participants received (positive or negative) false feedback about their capacity to stay in control during a bogus EEG session, and completed a computer task asking them to control the pace of a series of pictures. As hypothesized, participants provided with negative feedback about their capacity to stay in control (i.e., high negative beliefs about losing control) checked significantly more often which keys they should use to control the pictures, t(106.95) = 2.28, p = .02, d = .44, as compared to participants provided with positive feedback (i.e., low negative beliefs about losing control), demonstrating that manipulating beliefs about losing control can impact checking behaviour. Also, checking behaviour predicted a lower desire for control over the computer task’s pictures, r(131) = -.30, p < .001, such that compulsions may be seen as opportunities to re-establish disrupted perceptions of control. Results support the inclusion of beliefs about losing control in cognitive models of OCD.

Divisions:Concordia University > Faculty of Arts and Science > Psychology
Item Type:Thesis (Masters)
Authors:Gagné, Jean-Philippe
Institution:Concordia University
Degree Name:M.A.
Program:Psychology
Date:24 April 2017
Thesis Supervisor(s):Radomsky, Adam
Keywords:OCD; beliefs; checking; losing control; experiment; cognition.
ID Code:982494
Deposited By: JEAN-PHILIPPE GAGNE
Deposited On:10 Nov 2017 13:47
Last Modified:18 Jan 2018 17:55

References:

Abramowitz, J. S. (2006). The psychological treatment of obsessive-compulsive disorder. The Canadian Journal of Psychiatry, 51, 407-416. http://dx.doi.org/10.1177/070674370605100702

Adams, T. G., Riemann, B. C., Wetterneck, C. T., & Cisler, J. M. (2012). Obsessive beliefs predict cognitive behavior therapy outcome for obsessive compulsive disorder. Cognitive Behaviour Therapy, 41, 203-211. http://dx.doi.org/10.1080/16506073.2011.621969

Alcolado, G. M., & Radomsky, A. S. (2011). Believe in yourself: Manipulating beliefs about memory causes checking. Behaviour Research and Therapy, 49, 42-49. http://dx.doi.org/10.1016/j.brat.2010.10.001

Alcolado, G. M., & Radomsky, A. S. (2016). A novel cognitive intervention for compulsive checking: Targeting maladaptive beliefs about memory. Journal of Behavior Therapy and Experimental Psychiatry, 53, 75-83. http://dx.doi.org/10.1016/j.jbtep.2015.02.009

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Angst, J. (1994). The epidemiology of obsessive compulsive disorder. In E. Hollander, J. Zohar, D. Marazziti, & B. Oliver (Eds.), Current insight in obsessive compulsive disorder (pp. 93-104). West Sussex, UK: Wiley.

Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10, 176-181. http://dx.doi.org/10.1037/1040-3590.10.2.176

Arntz, A., Voncken, M., & Goosen, A. C. A. (2007). Responsibility and obsessive-compulsive disorder: An experimental test. Behaviour Research and Therapy, 45, 425-435. http://dx.doi.org/10.1016/j.brat.2006.03.016

Ball, S. G., Baer, L., & Otto, M. W. (1996). Symptom subtypes of obsessive-compulsive disorder in behavioral treatment studies: A quantitative review. Behaviour Research and Therapy, 34, 47-51. http://dx.doi.org/10.1016/0005-7967(95)00047-2

Bennett, S., & Dodge, T. (2007). Ethnic-racial differences in feelings of embarrassment associated with binge eating and fear of losing control. International Journal of Eating Disorders, 40, 454-459. http://dx.doi.org/10.1002/eat.20374

Braith, J. A., McCullough, J. P., & Bush, J. P. (1988). Relaxation-induced anxiety in a subclinical sample of chronically anxious subjects. Journal of Behavior Therapy and Experimental Psychiatry, 19, 193-198. http://dx.doi.org/10.1016/0005-7916(88)90040-7

Burger, J. M. (1984). Desire for control, locus of control, and proneness to depression. Journal of Personality, 52, 71-89. http://dx.doi.org/10.1111/j.1467-6494.1984.tb00551.x

Burger, J. M. (1991). The effects of desire for control in situations with chance-determined outcomes: Gambling behavior in lotto and bingo players. Journal of Research in Personality, 25, 196-204. http://dx.doi.org/10.1016/0092-6566(91)90015-I

Burger, J. M. (1992). Desire for control: Personality, social and clinical perspectives. New York, NY: Plenum Press.
Burger, J. M., & Cooper, H. M. (1979). The desirability of control. Motivation and Emotion, 3, 32
381-393. http://dx.doi.org/10.1007/BF00994052

Carr, A. T. (1974). Compulsive neurosis: A review of the literature. Psychological Bulletin, 81, 311-318. http://dx.doi.org/10.1037/h0036473

Chiang, B., Purdon, C., & Radomsky, A. S. (2016). Development and initial validation of the Fear of Guilt Scale for obsessive-compulsive disorder (OCD). Journal of Obsessive- Compulsive and Related Disorders, 11, 63-73. http://dx.doi.org/10.1016/j.jocrd.2016.08.006

Clark, D. A., Abramowitz, J., Alcolado, G. M., Alonso, P., Belloch, A., Bouvard, M., ... Ghisi, M. (2014). Part 3—A question of perspective: The association between intrusive thoughts and obsessionality in 11 countries. Journal of Obsessive-Compulsive and Related Disorders, 3, 292-299. http://dx.doi.org/10.1016/j.jocrd.2013.12.006

Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461- 470. http://dx.doi.org/10.1016/0005-7967(86)90011-2

Clark, D. M., Salkovskis, P. M., Öst, L. G., Breitholtz, E., Koehler, K. A., Westling, B. E., ... Gelder, M. (1997). Misinterpretation of body sensations in panic disorder. Journal of Consulting and Clinical Psychology, 65, 203. http://dx.doi.org/10.1037/0022- 006X.65.2.203

Colles, S. L., Dixon, J. B., & O'Brien, P. E. (2008). Loss of control is central to psychological disturbance associated with binge eating disorder. Obesity, 16, 608-614. http://dx.doi.org/10.1038/oby.2007.99

Conway, T. L., Vickers, R. R., & French, J. R. (1992). An application of person-environment fit theory: Perceived versus desired control. Journal of Social Issues, 48, 95-107. http://dx.doi.org/10.1111/j.1540-4560.1992.tb00886.x

Cougle, J. R., Salkovskis, P. M., & Wahl, K. (2007). Perception of memory ability and confidence in recollections in obsessive-compulsive checking. Journal of Anxiety Disorders, 21, 118-130. http://dx.doi.org/10.1016/j.janxdis.2006.03.015

Crawford, J. R., & Henry, J. D. (2003). The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology, 42, 111-131. http://dx.doi.org/10.1348/014466503321903544

Cuttler, C., Sirois-Delisle, V., Alcolado, G. M., Radomsky, A. S., & Taylor, S. (2013). Diminished confidence in prospective memory causes doubts and urges to check. Journal of Behavior Therapy and Experimental Psychiatry, 44, 329-334. http://dx.doi.org/10.1016/j.jbtep.2013.01.001

Deci, E. L., & Ryan, R. M. (2000). The "what" and "why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, 227-268. http://dx.doi.org/10.1207/S15327965PLI1104_01

Evans, G. W., Shapiro, D. H., & Lewis, M. A. (1993). Specifying dysfunctional mismatches between different control dimensions. British Journal of Psychology, 84, 255-273. http://dx.doi.org/10.1111/j.2044-8295.1993.tb02478.x

Fairburn, C. G., & Garner, D. M. (1986). The diagnosis of bulimia nervosa. International Journal of Eating Disorders, 5, 403-419. http://dx.doi.org/10.1002/1098-108X(198603)5:3<403::AID-EA T2260050302>3.0.CO;2-Z

Foa, E. B., Amir, N., Bogert, K. V., Molnar, C., & Przeworski, A. (2001). Inflated perception of responsibility for harm in obsessive–compulsive disorder. Journal of Anxiety Disorders, 15, 259-275. http://dx.doi.org/10.1016/S0887-6185(01)00062-7

Foa, E. B., Liebowitz, M. R., Kozak, M. J., Davies, S., Campeas, R., Franklin, M. E., ... Simpson, H. B. (2005). Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive- compulsive disorder. American Journal of Psychiatry, 162, 151-161. http://dx.doi.org/10.1176/appi.ajp.162.1.151

Froreich, F. V., Vartanian, L. R., Grisham, J. R., & Touyz, S. W. (2016). Dimensions of control and their relation to disordered eating behaviours and obsessive-compulsive symptoms. Journal of Eating Disorders, 4, 1-9. http://dx.doi.org/10.1186/s40337-016-0104-4

Garant, V., & Alain, M. (1995). Perception de contrôle, désir de contrôle et santé psychologique. Canadian Journal of Behavioural Science, 27, 251-267. http://dx.doi.org/10.1037/0008- 400X.27.3.251

Gelfand, L. A., & Radomsky, A. S. (2013). Beliefs about control and the persistence of cleaning behaviour: An experimental analysis. Journal of Behavior Therapy and Experimental Psychiatry, 44, 172-178. http://dx.doi.org/10.1016/j.jbtep.2012.08.002

Harter, S. (1978). Effectance motivation reconsidered: Toward a developmental model. Human Development, 21, 34-64. http://dx.doi.org/ 10.1159/000271574

Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44, 227-239. http://dx.doi.org/10.1348/014466505X29657

Karno, M., Golding, J. M., Sorenson, S. B., & Burnam, M. A. (1988). The epidemiology of obsessive-compulsive disorder in five US communities. Archives of General Psychiatry, 45, 1094-1099. http://dx.doi.org/10.1001/archpsyc.1988.01800360042006

Kline, R. B. (2009). Becoming a behavioral science researcher: A guide to producing research that matters. New York, NY: Guilford Press.

Ladouceur, R., Rhéaume, J., & Aublet, F. (1997). Excessive responsibility in obsessional concerns: A fine-grained experimental analysis. Behaviour Research and Therapy, 35, 423-427. http://dx.doi.org/10.1016/S0005-7967(96)00117-9

Lopatka, C., & Rachman, S. (1995). Perceived responsibility and compulsive checking: An experimental analysis. Behaviour Research and Therapy, 33, 673-684. http://dx.doi.org/10.1016/0005-7967(94)00089-3

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335-343. http://dx.doi.org/10.1016/0005-7967(94)00075-U

Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470. http://dx.doi.org/10.1016/S0005-7967(97)10031-6

McFall, M. E., & Wollersheim, J. P. (1979). Obsessive-compulsive neurosis: A cognitive- behavioral formulation and approach to treatment. Cognitive Therapy and Research, 3, 333-348. http://dx.doi.org/10.1007/BF01184447

McLaren, S., & Crowe, S. F. (2003). The contribution of perceived control of stressful life events and thought suppression to the symptoms of obsessive–compulsive disorder in both non-clinical and clinical samples. Anxiety Disorders, 17, 389–403. http://dx.doi.org/10.1016/S0887-6185(02)00224-4

Moulding, R., Coles, M. E., Abramowitz, J. S., Alcolado, G. M., Alonso, P., Belloch, A., ... & García-Soriano, G. (2014). Part 2—They scare because we care: The relationship between obsessive intrusive thoughts and appraisals and control strategies across 15 cities. Journal of Obsessive-Compulsive and Related Disorders, 3, 280-291. http://dx.doi.org/10.1016/j.jocrd.2014.02.006

Moulding, R., Doron, G., Kyrios, M., & Nedeljkovic, M. (2008). Desire for control, sense of control and obsessive-compulsive checking: An extension to clinical samples. Journal of Anxiety Disorders, 22, 1472-1479. http://dx.doi.org/10.1016/j.janxdis.2008.03.001

Moulding, R., & Kyrios, M. (2006). Anxiety disorders and control related beliefs: the exemplar of Obsessive-Compulsive Disorder (OCD). Clinical Psychology Review, 26, 573-583. http://dx.doi.org/10.1016/j.cpr.2006.01.009

Moulding, R., & Kyrios, M. (2007). Desire for control, sense of control and obsessive- compulsive symptoms. Cognitive Therapy and Research, 31, 759-772. http://dx.doi.org/10.1007/s10608-006-9086-x

Moulding, R., Kyrios, M., Doron, G., & Nedeljkovic, M. (2009). Mediated and direct effects of general control beliefs on obsessive compulsive symptoms. Canadian Journal of Behavioural Science, 41, 84-92. http://dx.doi.org/10.1037/a0014840

National Institute for Health and Clinical Excellence. (2005). Obsessive–compulsive disorder: core interventions in the treatment of obsessive–compulsive disorder and body dysmorphic disorder. London, UK: HMSO.

Obsessive Compulsive Cognitions Working Group. (1997). Cognitive assessment of obsessive- compulsive disorder. Behaviour Research and Therapy, 35, 667-681. http://dx.doi.org/10.1016/S0005-7967(97)00017-X

Obsessive Compulsive Cognitions Working Group. (2001). Development and initial validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory. Behaviour Research and Therapy, 39, 987-1006. http://dx.doi.org/10.1016/S0005- 7967(00)00085-1

Obsessive Compulsive Cognitions Working Group. (2003). Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory: Part I. Behaviour Research and Therapy, 41, 863-878. http://dx.doi.org/10.1016/S0005- 7967(02)00099-2

Obsessive Compulsive Cognitions Working Group. (2005). Psychometric validation of the Obsessive Belief Questionnaire and Interpretations of Intrusions Inventory—Part 2: Factor analyses and testing of a brief version. Behaviour Research and Therapy, 43,1527-1542. http://dx.doi.org/10.1016/j.brat.2004.07.010

O’Connor, K., Freeston, M. H., Gareau, D., Careau, Y., Dufour, M. J., Aardema, F., & Todorov, C. (2005). Group versus individual treatment in obsessions without compulsions. Clinical Psychology and Psychotherapy, 12, 87-96. http://dx.doi.org/10.1002/cpp.439

Olson, J. A., Landry, M., Appourchaux, K., & Raz, A. (2016). Simulated thought insertion: Influencing the sense of agency using deception and magic. Consciousness and Cognition, 43, 11-26. http://dx.doi.org/10.1016/j.concog.2016.04.010

Purdon, C., & Clark, D. A. (2002). The need to control thoughts. In R. O. Frost, & G. Steketee (Eds.), Cognitive approaches to obsessions and compulsions: Theory, assessment and treatment (pp. 29-43). Oxford, UK: Elsevier.

Pyle, R. L., Neuman, P. A., Halvorson, P. A., & Mitchell, J. E. (1991). An ongoing cross-sectional study of the prevalence of eating disorders in freshman college students. International Journal of Eating Disorders, 10, 667-677. http://dx.doi.org/10.1002/1098- 108X(199111)10:6<667::AID-EAT2260100605>3.0.CO;2-K

Rachman, S. (1993). Obsessions, responsibility and guilt. Behaviour Research and Therapy, 31, 149-154. http://dx.doi.org/10.1016/0005-7967(93)90066-4

Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793-802. http://dx.doi.org/10.1016/S0005-7967(97)00040-5

Rachman, S. (1998). A cognitive theory of obsessions: Elaborations. Behaviour Research and Therapy, 36, 385-401. http://dx.doi.org/10.1016/S0005-7967(97)10041-9

Rachman, S. (2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40, 625- 639. http://dx.doi.org/10.1016/S0005-7967(01)00028-6

Rachman, S. J., & Hodgson, R. J. (1980). Obsessions and compulsions. Englewood Cliffs, NJ: Prentice Hall.

Radomsky, A. S., Alcolado, G. M., Abramowitz, J. S., Alonso, P., Belloch, A., Bouvard, M., ... Garcia-Soriano, G. (2014). Part 1—You can run but you can't hide: Intrusive thoughts on six continents. Journal of Obsessive-Compulsive and Related Disorders, 3, 269-279. http://dx.doi.org/10.1016/j.jocrd.2013.09.002

Radomsky, A. S., Ouimet, A. J., Ashbaugh, A. R., Lavoie, S. L., Parrish, C. L., & O’Connor, K. P. (2006). Psychometric properties of the French and English versions of the Vancouver obsessional compulsive inventory and the symmetry ordering and arranging questionnaire. Cognitive Behaviour Therapy, 35, 164-173. http://dx.doi.org/10.1080/16506070600827198

Radomsky, A. S., & Rachman, S. (2004). Symmetry, ordering and arranging compulsive behaviour. Behaviour Research and Therapy, 42, 893-913. http://dx.doi.org/10.1016/j.brat.2003.07.001

Rassin, E., Merckelbach, H., Muris, P., & Spaan, V. (1999). Thought–action fusion as a causal factor in the development of intrusions. Behaviour Research and Therapy, 37, 231-237. http://dx.doi.org/10.1016/S0005-7967(98)00140-5

Reid, D., & Ware, E. E. (1974). Multidimensionality of internal versus external control: Addition of a third dimension and non-distinction of self versus others. Canadian Journal of Behavioural Science, 6, 131-142. http://dx.doi.org/10.1037/h0081862

Reuven-Magril, O., Dar, R., & Liberman, N. (2008). Illusion of control and behavioral control attempts in obsessive-compulsive disorder. Journal of Abnormal Psychology, 117, 334- 341. http://dx.doi.org/10.1037/0021-843X.117.2.334

Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23, 571-583. http://dx.doi.org/10.1016/0005- 7967(85)90105-6

Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37, S29-S52. http://dx.doi.org/10.1016/S0005-7967(99)00049-2

Sanavio, E. (1988). Obsessions and compulsions: the Padua Inventory. Behaviour Research and Therapy, 26, 169-177. http://dx.doi.org/10.1016/0005-7967(88)90116-7

Shafran, R. (1997). The manipulation of responsibility in Obsessive-Compulsive Disorder. British Journal of Clinical Psychology, 36, 397–407. http://dx.doi.org/10.1111/j.2044- 8260.1997.tb01247.x

Skinner, E. A. (1995). Perceived control, motivation, and coping. Thousand Oaks, CA: Sage. Skinner, E. A. (1996). A guide to constructs of control. Journal of Personality and Social Psychology, 71, 549. http://dx.doi.org/10.1037/0022-3514.71.3.549

Solem, S., Håland, Å. T., Vogel, P. A., Hansen, B., & Wells, A. (2009). Change in metacognitions predicts outcome in obsessive–compulsive disorder patients undergoing treatment with exposure and response prevention. Behaviour Research and Therapy, 47, 301-307. http://dx.doi.org/10.1016/j.brat.2009.01.003

Summerfeldt, L. J., Richter, M. A., Antony, M. M., & Swinson, R. P. (1999). Symptom structure in obsessive-compulsive disorder: A confirmatory factor-analytic study. Behaviour Research and Therapy, 37, 297-311. http://dx.doi.org/10.1016/S0005-7967(98)00134-X

Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Pearson Education Inc.
Taylor, S., Abramowitz, J. S., McKay, D., Calamari, J. E., Sookman, D., Kyrios, M., ... Carmin, C. (2006). Do dysfunctional beliefs play a role in all types of obsessive-compulsive disorder? Journal of Anxiety Disorders, 20, 85-97. http://dx.doi.org/10.1016/j.janxdis.2004.11.005

Thordarson, D. S., Radomsky, A. S., Rachman, S., Shafran, R., Sawchuk, C. N., & Hakstian, A. R. (2004). The Vancouver Obsessional Compulsive Inventory (VOCI). Behaviour Research and Therapy, 42, 1289-1314. http://dx.doi.org/10.1016/j.brat.2003.08.007

Thyer, B. A. (1985). Audio-taped exposure therapy in a case of obsessional neurosis. Journal of Behavior Therapy and Experimental Psychiatry, 16, 271-273. http://dx.doi.org/10.1016/0005-7916(85)90074-6

Tiggemann, M., & Raven, M. (1998). Dimensions of control in bulimia and anorexia nervosa: Internal control, desire for control, or fear of losing self-control? Eating Disorders, 6, 65-71. http://dx.doi.org/10.1080/10640269808249248

Tolin, D. F., Woods, C. M., & Abramowitz, J. S. (2003). Relationship between obsessive beliefs 42
and obsessive compulsive symptoms. Cognitive Therapy and Research, 27, 657-669. http://dx.doi.org/10.1023/A:1026351711837

Turner, S. M., Beidel, D. C., Dancu, C. V., & Keys, D. J. (1986). Psychopathology of social phobia and comparison to avoidant personality disorder. Journal of Abnormal Psychology, 95, 389-394. http://dx.doi.org/10.1037/0021-843X.95.4.389

van Oppen, P., van Balkom, A. J., de Haan, E., & van Dyck, R. (2005). Cognitive therapy and exposure in vivo alone and in combination with fluvoxamine in obsessive-compulsive disorder: A 5-year follow-up. The Journal of Clinical Psychiatry, 66, 1415-1422. http://dx.doi.org/10.4088/JCP.v66n1111

White, R. W. (1959). Motivation reconsidered: The concept of competence. Psychological Review, 66, 297-333. http://dx.doi.org/10.1037/h0040934

Wilhelm, S., Berman, N. C., Keshaviah, A., Schwartz, R. A., & Steketee, G. (2015). Mechanisms of change in cognitive therapy for obsessive compulsive disorder: Role of maladaptive beliefs and schemas. Behaviour Research and Therapy, 65, 5-10. http://dx.doi.org/10.1016/j.brat.2014.12.006

Woody, S. R., Whittal, M. L., & McLean, P. D. (2011). Mechanisms of symptom reduction in treatment for obsessions. Journal of Consulting and Clinical Psychology, 79, 653-664. http://dx.doi.org/10.1037/a0024827

World Health Organization. (1999). World health report 1999: Making a difference. New York, NY: Author.
All items in Spectrum are protected by copyright, with all rights reserved. The use of items is governed by Spectrum's terms of access.

Repository Staff Only: item control page

Downloads per month over past year

Research related to the current document (at the CORE website)
- Research related to the current document (at the CORE website)
Back to top Back to top